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March 2, 2026 Get Citation Alerts Download PDF Add Note

Holly R. v. Frank Bisignano, Commissioner of Social Security

District Court, E.D. Washington

• Citations: None known
• Docket Number: 4:25-cv-05091

• Precedential Status: Unknown Status

• Opinion

• Authorities (18)

• Cited By (0)

• Summaries (0)

• Similar Cases (60.6K)

• PDF

Trial Court Document

1

FILED IN THE

U.S. DISTRICT COURT

EASTERN DISTRICT OF WASHINGTON
2

Mar 02, 2026

3

SEAN F. MCAVOY, CLERK

4

UNITED STATES DISTRICT COURT

5 EASTERN DISTRICT OF WASHINGTON

6

HOLLY R.,1 No. 4:25-cv-05091-EFS

7

8 Plaintiff,

ORDER REVERSING THE

9 v. ALJ’S DENIAL OF BENEFITS,

AND REMANDING FOR

10 FRANK BISIGNANO, FURTHER PROCEEDINGS

Commissioner of Social Security,

11

12 Defendant.

13

14

Due to bilateral knee pain, arthritis, chronic fatigue, foot pain,

15

16 anxiety, panic attacks, depression, carpal tunnel syndrome,

17 degenerative joint disease of the right shoulder, rotator cuff injury of

18

the right shoulder, tendinosis of the right arm and wrist, and

19

20

21 1 For privacy reasons, Plaintiff is referred to by first name and last

22

initial or as “Plaintiff.” See LCivR 5.2(c).

23

1 DeQuervain’s tenosynovitis, Plaintiff Holly R. claims that she is unable

2 to work fulltime and applied for supplemental security income benefits.

3

She appeals the denial of benefits by the Administrative Law Judge

4

(ALJ) on the grounds that the ALJ improperly found her headaches not

5

to be severe at Step Two and improperly analyzed the opinions of Rikki

6

Cook, LMHC, and David Davis-Boozler, MD; and the ALJ improperly

7

8 assessed Plaintiff’s credibility. As is explained below, the ALJ erred.

9 This matter is remanded for further proceedings.

10

I. Background

11

In November 2019, Plaintiff filed an application for benefits under

12

Title 16, claiming disability beginning January 1, 2019,2 based on the

13

physical and mental impairments noted above.3 Plaintiff’s claim was

14

15 denied at the initial and reconsideration levels.4

16 After the agency denied Plaintiff benefits, ALJ Marie Palachuk

17

held a telephone hearing in June 2022, at which Plaintiff appeared with

18

19

20 2 This was later amended to October 15, 2019, as noted below.

21 3 AR 183-194, 215.

22

4 AR 88, 101, 104.

23

1 her representative.5 Plaintiff and a vocational expert testified.6 ALJ

2 Palachuk issued an unfavorable decision on August 19, 2022.7 The

3

Appeals Council denied Plaintiff’s timely requested review of the ALJ’s

4

decision.8 Plaintiff filed suit in this Court, and the Court entered

5

judgment on April 2, 2024, finding in Plaintiff’s favor, reversing the

6

ALJ’s denial, and remanding the case for further proceedings.9 On

7

8 September 24, 2024, the Appeals Council entered an Order remanding

9 the case, consistent with this Court’s judgment.10

10

On May 8, 2025, Plaintiff appeared with her attorney for a

11

hearing before ALJ Shawn Bozarth.11 Plaintiff and a vocational expert

12

13

14

15

5 AR 36-58.

16

6 Id.

17

7 AR 15-33.

18

8 AR 1-6, 176.

19

20 9 AR 1211-1215, 1216-1258, 1259.

21 10 AR 1260.

22

11 AR 1155-1185.

23

1 testified.12 After the hearing, the ALJ issued a decision denying

2 benefits.13 The ALJ found Plaintiff’s alleged symptoms were not entirely

3

consistent with the medical evidence and the other evidence.14 As to

4

medical opinions, the ALJ found:

5

• The opinions of state agency evaluators Matthew Comrie,

6

PsyD, and Patricia Kraft, PhD, to be not very persuasive.

7

8 • The opinions of state agency physicians Robert Stuart, MD,

9 and Gordon Hale, MD, to be not entirely persuasive.

10

• The opinions of consultative examiner Linda Lindman, PhD,

11

to be not entirely persuasive.

12

• The opinions of David Davis-Boozler, MD, to be somewhat

13

14 persuasive.

15 • The opinions of Rikki Cook, LMHC, to be not persuasive.15

16

17

12 Id.

18

13 AR 1126-1150. Per 20 C.F.R. § 416.920 (a)–(g), a five-step evaluation

19

20 determines whether a claimant is disabled.

21 14 AR 27-32.

22

15 AR 1140-1142.

23

1 As to the sequential disability analysis, the ALJ found:

2 • Step one: Plaintiff had not engaged in substantial gainful

3

activity since October 15, 2019, the date of her application.

4

• Step two: Plaintiff had the following medically determinable

5

severe impairments: degenerative joint disease of the

6

bilateral knees; patellofemoral arthritis of the right knee;

7

8 degenerative joint disease of the right shoulder; carpal

9 tunnel syndrome of the right upper extremity; status post

10

right wrist arthroscopy; status post DeQuervain’s

11

tenosynovitis surgery of the right upper extremity; obesity;

12

depression; adjustment disorder; and anxiety disorder.

13

14 • Step three: Plaintiff did not have an impairment or

15 combination of impairments that met or medically equaled

16 the severity of one of the listed impairments.

17

• RFC: Plaintiff had the RFC to perform light work with the

18

following exceptions:

19

[She] can never climb ladders, ropes, or scaffolds. [She]

20

can occasionally climb ramps and stairs, balance, stoop,

kneel, crouch, and crawl. [She] can frequently reach and

21

handle with her right upper extremity. [She] can have

22 no exposure to working in high, exposed areas and

moving mechanical parts. [She] can have occasional

23

1 exposure to extreme cold, extreme heat, and vibration.

[She] can understand, remember, and carry out simple

2 instructions. [She] can perform work without a specific

production rate pace, such as an assembly line or hourly

3

production quotas as well as piece work. [She] can make

4 simple work-related decisions. [She] can occasionally

deal with changes in a routine work setting. [She] can

5 occasionally interact with supervisors, coworkers, and

never with the public.

6

      •  Step four: Plaintiff has no past relevant work.                 

7

8 • Step five: considering Plaintiff’s RFC, age, education, and

9 work history, Plaintiff could perform work that existed in

10

significant numbers in the national economy, such as a

11

routing clerk (DOT 222.687-022), marker (DOT 209.587-

12

034), and router (DOT 222.587-038).16

13

Plaintiff timely requested review of the ALJ’s decision by the

14

15 Appeals Council and now this Court.17

16

17

18

19

20

21 16 AR 1131-1143.

22

17 AR 176.

23

1 II. Standard of Review

2 The ALJ’s decision is reversed “only if it is not supported by

3

substantial evidence or is based on legal error,”18 and such error

4

impacted the nondisability determination.19 Substantial evidence is

5

“more than a mere scintilla but less than a preponderance; it is such

6

relevant evidence as a reasonable mind might accept as adequate to

7

8 support a conclusion.”20

9

10

18 Hill v. Astrue, 698 F.3d 1153, 1158 (9th Cir. 2012). See 42 U.S.C. §

11 405(g).

12

13 19 Molina v. Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012), superseded on

14 other grounds by 20 C.F.R. § 416.920 (a) (recognizing that the court may

15

not reverse an ALJ decision due to a harmless error—one that “is

16

inconsequential to the ultimate nondisability determination”).

17 20 Hill, 698 F.3d at 1159 (quoting Sandgathe v. Chater, 108 F.3d 978,

18

980 (9th Cir. 1997)). See also Lingenfelter v. Astrue, 504 F.3d 1028, 1035
19

20 (9th Cir. 2007) (The court “must consider the entire record as a whole,

21 weighing both the evidence that supports and the evidence that detracts

22

from the Commissioner's conclusion,” not simply the evidence cited by

23

1 III. Analysis

2 Plaintiff seeks relief from the denial of disability on three grounds.
3

She argues the ALJ erred when he found headaches to be a non-severe

4

impairment, erred when evaluating the medical opinions and erred

5

when evaluating Plaintiff’s subjective complaints.21 As is explained

6

below, the Court concludes that the ALJ consequentially erred in his

7

8 evaluation of the medical opinion evidence and Plaintiff’s subjective

9 complaints.

10

A. Medical Opinions: Plaintiff establishes consequential error.

11

Plaintiff argues the ALJ erred in his evaluation of the medical

12

opinions.22 Specifically, Plaintiff argues that the ALJ again erred in

13

14

15

16

the ALJ or the parties.) (cleaned up); Black v. Apfel, 143 F.3d 383, 386

17

(8th Cir. 1998) (“An ALJ’s failure to cite specific evidence does not

18

indicate that such evidence was not considered[.]”).

19

20 21 ECF No. 11.

21 22 An ALJ must consider and articulate how persuasive she found each

22

medical opinion, including whether the medical opinion was consistent

23

1 rejecting the disabling opinions of LMHC Cook and Dr. Davis-Boozler

2 and in part violated the remand order previously issued by this Court.

3

The Commissioner counter-argues that the ALJ reasonably evaluated

4

the opinions of Dr. Davis-Boozler and LMHC Cook.23 The Court

5

concludes that the ALJ violated the Court’s remand order by failing to

6

consider Plaintiff’s limitations during the period prior to her knee

7

8 replacement surgery and the subsequent period of recovery from that

9 surgery as a separate period of more than 12 months.

10

1. Standard

11

The ALJ was required to consider and evaluate the

12

persuasiveness of the medical opinions and prior administrative

13

14 medical findings.24 The factors for evaluating the persuasiveness of

15 medical opinions and prior administrative medical findings include, but

16

are not limited to, supportability, consistency, relationship with the

17

18

with and supported by the record. 20 C.F.R. § 416.920c(a)–(c); Woods v.

19

20 Kijakazi, 32 F.4th 785, 792 (9th Cir. 2022).

21 23 ECF No. 13.

22

24 20 C.F.R. § 416.920c(a), (b).

23

1 claimant, and specialization.25 Supportability and consistency are the

2 most important factors,26 and the ALJ must explain how he considered

3

the supportability and consistency factors when reviewing the medical

4

opinions and support his explanation with substantial evidence.27 The

5

ALJ may consider, but is not required to discuss the following

6

additional factors: the source’s relationship to Plaintiff such as length of
7

8 the treatment, purpose of the treatment relationship and whether the

9 source examined Plaintiff, as well as whether the source had advanced

10

training or experience to specialize in the area of medicine in which the
11

opinion was being given.28 When considering the ALJ’s findings, the

12

13

14 25 20 C.F.R. § 416.920c(c)(1)–(5).

15

26 Id. § 416.920c(b)(2).

16

27 Id. § 416.920c(b)(2); Woods v. Kijakazi, 32 F.4th a at 785 (“The agency
17

must articulate . . . how persuasive it finds all of the medical opinions
18

from each doctor or other source and explain how it considered the

19

20 supportability and consistency factors in reaching these findings.”)

21 (cleaned up).

22

28 Id.

23

1 Court is constrained to the reasons and supporting explanation offered

2 by the ALJ.29

3

2. Plaintiff’s Testimony

4

At her first hearing in June 2022, Plaintiff testified that in

5

October of 2019 she was trying to do some in-home childcare but was

6

7 not able to watch children properly due to panic attacks.30 When she got

8 the panic attacks, it was hard to do anything.31 Plaintiff stated that she
9

able to complete state training in 2021 to be paid by the state to care for
10

the children of a friend.32 Plaintiff said that she watched her friend’s

11

one-year-old and four-year-old children on a full-time basis until her

12

friend moved to Utah.33 Plaintiff said that she started watching them at

13

14 the friend’s home but later watched them at her own home to reduce the

15

16

29 See Burrell v. Colvin, 775 F.3d 1133, 1138 (9th Cir. 2014) (recognizing
17

court review is constrained to the reasons the ALJ gave).

18

30 AR 41-42.

19

20 31 Id. 21 32 Id. 22

33 AR 43.

23

1 number of panic attacks.34 She said that she has panic attacks four

2 times a week.35

3

Plaintiff said that when she has a panic attack she has a hard

4

time breathing and needs to be alone for thirty to forty-five minutes.36

5

The coping techniques do not always work and half of the time she does

6

not fully recover for an extended time.37 She has missed appointments

7

8 because she could not leave the house due to a panic attack.38 She said

9 that if she was watching the children when she had a panic attack she

10

would put on a show for them and would then sit by herself and try to

11

calm down.39 When the children were in the room, it took longer to calm

12

down.40 Plaintiff said that she tried to do a day of shadowing a delivery
13

14

15

34 Id. 16

35 Id. 17

36 AR 44.

18

37 Id. 19

20 38 Id. 21 39 AR 45.

22

40 Id. 23

1 driver for Crumbl Cookies.41 If she were to get a job as a fill-in delivery
2 driver she would need to be able to bake, box, and deliver cookies.42

3

Plaintiff thought she would be able to do the job because it had limited

4

public contact but on her first day she had a panic attack.43

5

Plaintiff said that eight percent of the time that she leaves home

6

she will have a panic attack so she is usually either late for her

7

8 appointments or needs to cancel them.44 She said that she needs to go

9 home after being out for an hour.45 Plaintiff testified that earlier in the
10

year she had not been able to take her medication because she did not

11

have a primary care provider and her mental health declined as a

12

result, with her having more panic attacks.46

13

14

15

16

41 Id. 17

42 AR 45-46.

18

43 AR 46.

19

20 44 Id. 21 45 AR 47.

22

46 Id. 23

1 Plaintiff testified that prior to her knee replacement surgery she

2 could only stand for twenty to thirty minutes a day, but that after the

3

surgery she was able to walk on it for up to twenty-five minutes a day

4

and stand for longer.47 Plaintiff said that before the surgery she could

5

only stand for up to thirty minutes about three times a day and that

6

after the surgery she could stand for that amount of time about six

7

8 times a day.48 She testified that it took about six months of recovery

9 after the surgery for her to be able to stand or walk for that long.49

10

Plaintiff stated that she can lift ten to fifteen pounds and that her hand
11

will go numb if she lifts more.50 She also said that her knee will lock or
12

give out if she lifts more than fifteen pounds.51 She said that when she

13

was babysitting she would have the child crawl into her lap so she did

14

15

16

17

47 AR 48.

18

48 AR 48-49.

19

20 49 AR 49.

21 50 Id. 22

51 AR 50.

23

1 not need to lift them.52 She said that her medication makes it hard to

2 focus and she has a hard time focusing when she is out in public with

3

more than three or four people.53 She said that when she has a panic

4

attack it is hard to concentrate on anything.54 She said that sometimes

5

she cannot focus for the whole day and needs to lie down for about forty-
6

five minutes to rest due to low energy.55

7

8 3. Relevant Medical Records

9

a. Physical impairments

10

i. Trios Health

11

On March 12, 2019, Plaintiff presented to ARNP Joshua

12

Anderson, requesting a new referral for insurance purposes to Dr. Jacob

13

14 Stanfield for her knee.56 On examination, Plaintiff reported that she

15 stopped seeing her psychiatrist due to personality conflict and was

16

17

52 Id. 18

53 AR 51.

19

20 54 Id. 21 55 AR 52.

22

56 AR 342.

23

1 recently experiencing depression and anxiety with fatigue.57 She was in

2 no acute distress and was ambulating normally.58 She was diagnosed

3

with pain in her right knee and major depressive disorder.59

4

On March 28, 2019, Plaintiff presented to ARNP Anderson with

5

complaints of injury to her left wrist after tripping and falling.60 On

6

examination, she was ambulating normally, was in no acute distress,

7

8 and had tenderness to palpation over the left distal ulna.61 An x-ray

9 indicated no fracture.62

10

On May 13, 2019, Plaintiff presented to ARNP Anderson with

11

acute pharyngitis.63 On examination, she had muscle ache, muscle

12

weakness and pain in her right shoulder with abduction and

13

14

15

57 Id. 16

58 Id. 17

59 AR 342-343.

18

60 AR 340.

19

20 61 Id. 21 62 AR 345.

22

63 AR 336.

23

1 circumduction, and was tender on palpation and was painful with

2 abduction and extension beyond 90 degrees or with any

3

circumduction.64

4

On September 3, 2019, Plaintiff presented to Adam Smith, DO, at

5

Trios Health for an annual OB-GYN exam.65 On examination, Plaintiff

6

reported hot flashes as well as knee pain and the need for a knee

7

8 replacement.66

9 ii. Kadlec Orthopedic

10

On December 13, 2018, Plaintiff presented to Doyle Miller, MD,

11

with complaints of progressively worsening pain in her right knee.67 She

12

reported constant aching with a stabbing pain rated at a 9 out of 10,

13

and swelling and locking of the knee.68 Plaintiff also reported that the

14

15

16

17

64 AR 338.

18

65 AR 331.

19

20 66 AR 333.

21 67 AR 407.

22

68 Id. 23

1 pain was worse at night.69 On examination, Plaintiff was anxious with

2 dysphoric mood and sleep disturbance, and had tenderness to the

3

medial joint line and medial patellar facet.70 All results were within

4

normal limits other than tenderness in the patellar region.71 Plaintiff

5

was sent for an MRI of the right knee, which revealed advanced

6

degeneration of the patellofemoral compartment with full-thickness

7

8 chondral loss; large knee-joint effusion; and degenerative free edge

9 fraying of the lateral meniscal body.72 Plaintiff was diagnosed with right
10

knee degenerative joint disease (DJD) with severe patellofemoral

11

arthritis.73 Dr. Miller advised that Plaintiff should not have

12

arthroscopic surgery due to her age but should attempt to manage the

13

14

15

16

17

69 Id. 18

70 AR 408-409.

19

20 71 Id. 21 72 AR 408-409.

22

73 AR 409.

23

1 condition with conservative treatment and get a total knee replacement

2 if her pain persisted.74

3

On March 13, 2019, Plaintiff presented to Jacob Stanfield, MD,

4

following an injection.75 Plaintiff reported continued severe pain as a

5

result of her “significant patellofemoral osteoarthritis.”76 Dr. Stanfield
6

noted that Dr. Miller felt arthroscopic surgery would not be beneficial

7

8 and noted that on examination Plaintiff experienced tenderness in the

9 medial joint line, medial retinaculum, lateral retinaculum, and Plica.77

10

Dr. Stanfield thought that Plaintiff would be a good candidate for knee

11

replacement but should exhaust conservative treatments such as

12

injections and radiofrequency ablation due to her age.78

13

14

15

16

17

74 Id. 18

75 AR 410.

19

20 76 Id. 21 77 Id. 22

78 AR 411.

23

1 On March 17, 2019, Plaintiff underwent an intracapsular

2 lidocaine injection to the right knee performed by Arash Motagi, DO.79

3

On examination, Plaintiff’s gait was antalgic.80 Plaintiff was diagnosed

4

with chronic pain in her right knee “due to significant amount of

5

degeneration and arthritis in her right knee.”81 Dr. Motaghi noted that

6

Plaintiff had tried conservative therapies with minimal relief and he

7

8 recommended a right knee genicular nerve block, as doctors were

9 attempting to postpone knee replacement due to Plaintiff’s age.82 On

10

May 15, 2019, Plaintiff returned to Dr. Motaghi, reporting only mild

11

relief from the nerve block performed.83Dr. Motaghi assessed Plaintiff

12

with chronic pain of the right knee and opined that she received eighty-

13

14

15

16

17

79 Id. 18

80 AR 415.

19

20 81 Id. 21 82 Id. 22

83 AR 416-417.

23

1 percent relief from the genicular nerve blocks.84 Dr. Motaghi suggested

2 that Plaintiff should undergo radiofrequency ablation.85

3

On June 10, 2019, Plaintiff presented to Dr. Stanfield reporting

4

that her recent radiofrequency ablation had given her only minimal

5

relief and that she needed a steroid injection in her knee.86 On

6

examination, Plaintiff had tenderness at the medial joint line, medial

7

8 retinaculum, lateral retinaculum, and Plica.87 Dr. Stanfield

9 administered an injection and assessed her as suffering from primary

10

osteoarthritis of the right knee.88 He opined that Plaintiff was young for
11

a knee replacement surgery but it was likely her only option due to

12

significant degenerative changes in her knee.89 Dr. Stanfield

13

recommended that Plaintiff try to manage symptoms for as long as

14

15

16

84 AR 420.

17

85 Id. 18

86 AR 421.

19

20 87 Id. 21 88 AR 422.

22

89 Id. 23

1 possible before scheduling the knee replacement.90 On September 11,

2 2019, Plaintiff presented to Dr. Stanfield seeking an injection for her

3

right knee.91 On examination, Plaintiff exhibited pain and crepitus with

4

motion.92 Dr. Stanfield noted that Plaintiff had attempted injections,

5

radiofrequency ablation, bracing, and anti-inflammatories, as well as

6

physical therapy but had not gotten relief.93 Because pain symptoms

7

8 were interfering with her activities of daily living, Plaintiff was seeking
9 permanent treatment.94 Dr. Stanfield noted that conservative measures

10

had failed and that he had counseled against knee replacement if

11

possible, but symptoms were severe and conservative measures were

12

not helpful, so knee replacement would be considered in the summer.95

13

14

15

16

90 Id. 17

91 AR 422-423.

18

92 AR 423.

19

20 93 AR 424.

21 94 Id. 22

95 AR 425.

23

1 iii. Dr. Davis-Boozler

2 On January 24, 2021, Plaintiff was examined by David Davis-

3

Boozler, MD, at the request of the Commissioner.96 Dr. Davis-Boozler

4

noted that he reviewed the records of Dr. Stanfield from June 10, 2019,

5

and December 18, 2019.97 Plaintiff reported that she had bilateral knee

6

pain which progressed over the last two to three years, and that she had

7

8 a right knee replacement and later a manipulation under anesthesia.98

9 She also reported left foot pain due to a ganglion cyst and chronic

10

fatigue for the past twelve months.99 Plaintiff reported that she lived

11

with her three children and ran a babysitting service, and was able to

12

do such activities as cooking, cleaning, shopping, and yard work.100 On

13

examination, Plaintiff’s blood pressure was elevated; she was

14

15 appropriately dressed and showed no unusual habits or distress; she

16

17

96 AR 850-856.

18

97 AR 851.

19

20 98 Id. 21 99 AR 852.

22

100 Id. 23

1 had a normal gait and was able to rise from a chair and the table

2 without help; Plaintiff could walk on her heels and toes, balance, bend

3

and squat halfway; straight leg testing was negative; motor function

4

and strength were normal in all extremities; range of motion was

5

normal in all extremities with the exception of limited flexion in the

6

knees; and sensory examination was normal in all extremities.101

7

8 Dr. Davis-Boozler diagnosed Plaintiff with bilateral knee pain with good

9 prognosis; left foot pain with good prognosis; and chronic fatigue with

10

good prognosis.102

11

An X-ray of the left foot taken on January 26, 2021, indicated no

12

acute injury.103

13

14 4. Analysis

15 a. The ALJ’s consideration of Dr. Davis-Boozler’s opinion

16

regarding Plaintiff’s ability to stand

17

18

19

20 101 AR 853-855.

21 102 AR 855.

22

103 AR 857.

23

1 Dr. Davis-Boozler examined Plaintiff at the request of the

2 Commissioner on January 24, 2021.104 Dr. Davis-Boozler conducted a

3

fairly thorough examination and reviewed treatment records from

4

Dr. Stanfield which documented a total knee replacement in Plaintiff’s

5

right leg.105

6

Dr. Davis-Boozler assessed that Plaintiff is capable of walking at

7

8 least four hours, has no limitation in sitting, does not need an assistive
9 device, and can lift twenty pounds occasionally and ten pounds

10

frequently.106 He listed the following postural limitations: no climbing
11

or balancing and occasional stooping, kneeling, crouching, and

12

crawling.107 He opined that Plaintiff had no manipulative limitations

13

and no environmental limitations.108 With regard to the limitation to

14

15 sitting, Dr. Davis-Boozler noted that the four-hour limitation to sitting
16

17

104 AR 850-856.

18

105 Id. 19

20 106 AR 855.

21 107 AR 855-856.

22

108 AR 856.

23

1 might increase or relax based upon Plaintiff’s recovery from right knee

2 arthroplasty.109

3

The ALJ found Dr. Davis-Boozler’s opinion somewhat persuasive

4

and in doing so stated the following reasoning:

5

Additionally, the undersigned considered the opinion of the

6

internal medicine consultative examiner, David Davis-

Boozer, M.D., and finds it somewhat persuasive. Dr. Davis-

7

Boozer examined the claimant and opined that the claimant

8 can stand at least four hours and that this may change

either to increase or relax this restriction based on future

9 development of the flexibility of her right knee arthroplasty.

He further opined that the claimant had no sitting

10

limitations, did not require an assistive device, could lift and

11 carry 20 pounds occasionally and 10 pounds frequently, and

could occasionally stoop, kneel, crouch, and crawl (Exhibit

12 13F). Dr. Davis-Boozer’s opinion appeared to be generally

supported by his examination of the claimant. For instance,

13

the claimant had a normal gait, rose from a chair unassisted,

tandem walked, and squatted halfway. The claimant also

14

had normal range of motion of all joints other than limited

15 flexion of her knees and had normal motor strength other

than 4/5 strength in the right lower extremity. However, the

16 opinion is not entirely consistent with the evidence of record

as a whole. Dr. Davis-Boozer examined the claimant in

17

January 2021, eight months after the claimant had

18 undergone her right knee arthroplasty and he acknowledged

that the claimant could stand and walk at least four hours

19 and may be able to stand and walk more depending on how

she further healed. As mentioned above, the evidence has

20

not shown the claimant to have sought out or to have

21

22

109 AR 855.

23

1 received medical treatment for her knee impairments since

prior to this examination (Exhibit 11F/6). Accordingly, the

2 evidence does not demonstrate a further decline in her knee

functioning or that healing did not continue to take place.

3

The claimant also had a normal gait and no motor or sensory

4 deficits in records from June 2022 (Exhibit 23F/247). She

similarly was noted to have a normal gait and station in

5 April 2024 records (Exhibit 24F/88). Therefore, the

undersigned does not any specific limitations to be

6

warranted in regard to the claimant’s ability to stand and/or

walk. The undersigned also notes that the claimant has

7

developed right upper extremity impairments since Dr.

8 Davis-Boozer examined the claimant (Exhibits 22F/60-65;

23F/1, 6, 37, 123, 126, 132, 188, 191). The undersigned has

9 fully considered the effects of these impairments in forming

the above listed residual functional capacity. Accordingly,

10

Dr. Davis-Boozer’s opinion is only somewhat persuasive.110

11

As the Court noted in its prior Order, Dr. Davis-Boozler was a

12

consultative examiner who examined Plaintiff and rendered opinions at

13

the request of the Commissioner. As an experienced consultant for the

14

15 Administration, he was familiar with the regulations and policies and

16 was aware that the exertional limitations of light work required

17

standing or walking for six hours. He did not opine that Plaintiff was

18

capable of standing and walking for six hours. Dr. Davis-Boozler stated

19

clearly that Plaintiff was not fully recovered from her right knee

20

21

22

110 AR 1141.

23

1 replacement and that at the time of her examination she could

2 reasonably be expected to be able to stand and/or walk for “at least” four
3

hours, indicating that the ability to stand or walk for longer periods was
4

not clear pending recovery.

5

The ALJ’s reasoning is flawed because he failed to properly

6

consider Dr. Davis-Boozler’s opinion in the context of Plaintiff’s recovery
7

8 period following her right knee replacement as well as the period prior

9 to Plaintiff’s surgery. While the ALJ is correct that the records indicate
10

that Plaintiff’s function improved following her right knee replacement,

11

they also show that prior to the surgery she was quite limited. A

12

claimant’s improvement with treatment is “an important indicator of

13

the intensity and persistence of . . . symptoms.”111 Symptom

14

15

16

17

18

111 20 C.F.R. § 416.929 (c)(3). See Warre v. Comm'r of Soc. Sec. Admin.,

19

20 439 F.3d 1001, 1006 (9th Cir. 2006) (“Impairments that can be

21 controlled effectively with medication are not disabling for the purpose

22

of determining eligibility for SSI benefits.”).

23

1 improvement, however, must be weighed within the context of an

2 “overall diagnostic picture.”112

3

The ALJ erred by discounting both Plaintiff’s symptom reports

4

and Dr. Davis-Boozler’s opinions regarding her ability to walk for the

5

entire alleged disability period. The record does not show that Plaintiff’s
6

symptoms regarding her right knee improved until at the very least

7

8 seven months after her surgery, and if Dr. Davis-Boozler’s opinion is to

9 be given full-credit, even as of January 2021 Plaintiff had not improved

10

to the extent that she could engage in light work.

11

The record evidence that for a period prior to her surgery and for

12

at least nine months thereafter, Plaintiff’s ability to stand and walk was
13

significantly limited. Because the ability to engage in a full range of

14

15 light work would require Plaintiff to stand and walk for a period of up

16 to six hours per day, the limitation would be disabling. While Dr. Davis-
17

Boozler has opined to limitations consistent with an inability to work at
18

19

20 112 Holohan v. Massanari, 246 F.3d1195, 1205 (9th Cir. 2001); see also

21 Lester v. Chater, 81 F.3d 821, 833 (9th Cir. 1995) (“Occasional symptom-

22

free periods ... are not inconsistent with disability.”).

23

1 greater than the sedentary level of exertion, it is unclear at what date

2 those limitations started and on what date they ended or were expected

3

to end.

4

The Court concludes that remand is warranted for the ALJ to

5

properly consider the opinion evidence to evaluate the record, and to

6

obtain medical expert testimony or opinion as to Plaintiff’s limitations

7

8 throughout all relevant periods, including the period preceding

9 Plaintiff’s surgery and the period of recovery immediately following it.

10

5. Summary

11

Because the ALJ did not give good reasons for his evaluation of

12

the medical opinions of Dr. Davis-Boozler, and failed to develop the

13

14 record as to Plaintiff’s limitations pre-surgery and post-surgeical

15 recovery, a remand is warranted for development of the record.

16

B. Plaintiff’s Subjective Complaints: Plaintiff establishes

17

consequential error.

18

Plaintiff argues the ALJ failed to properly assess her subjective

19

complaints. The Court concludes that for the later period beginning

20

21 January 9, 2023, to date, the ALJ failed to properly develop the record

22 as to medical opinion evidence regarding Plaintiff’s shoulder injuries

23

1 and failed to consider the consistency of Plaintiff’s testimony regarding
2 her limitations in reaching with the medical evidence in the record.

3

1. Standard

4

When examining a claimant’s symptoms, the ALJ utilizes a two-

5

step inquiry. “First, the ALJ must determine whether there is objective

6

7 medical evidence of an underlying impairment which could reasonably

8 be expected to produce the pain or other symptoms alleged.”113 Second,

9

“[i]f the claimant meets the first test and there is no evidence of

10

malingering, the ALJ can only reject the claimant’s testimony about the

11

severity of the symptoms if [the ALJ] gives ‘specific, clear and

12

convincing reasons’ for the rejection.”114 General findings are

13

14 insufficient; rather, the ALJ must identify what symptom claims are

15 being discounted and what evidence undermines these claims.115 “The

16

17

113 Molina, 674 F.3d at 1112.

18

114 Ghanim v. Colvin, 763 F.3d 1154, 1163 (9th Cir. 2014) (quoting

19

20 Lingenfelter, 504 F.3d at 1036).

21 115 Id. (quoting Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1995), and

22

Thomas v. Barnhart, 278 F.3d 947, 958 (9th Cir. 2002) (requiring the

23

1 clear and convincing standard is the most demanding required in Social

2 Security cases.”116 Therefore, if an ALJ does not articulate specific,

3

clear, and convincing reasons to reject a claimant’s symptoms, the

4

corresponding limitations must be included in the RFC.117

5

1. Plaintiff’s Testimony118

6

7 At her second hearing, Plaintiff testified that she graduated high

8 school and had been self-employed in 2021 and 2022 watching a friend’s

9

10

11

ALJ to sufficiently explain why he discounted claimant’s symptom

12

13 claims)).

14 116 Garrison v. Colvin, 759 F.3d 995, 1015 (9th Cir. 2014) (quoting

15

Moore v. Comm’r of Soc. Sec. Admin., 278 F.3d 920, 924 (9th Cir. 2002)).

16

117 Lingenfelter, 504 F.3d at 1035 (“[T]he ALJ failed to provide clear and
17

convincing reasons for finding Lingenfelter’s alleged pain

18

and symptoms not credible, and therefore was required to include these

19

20 limitations in his assessment of Lingenfelter’s RFC.”).

21 118 This summary focuses on Plaintiff’s testimony during the second

22

hearing, as the Court finds that the ALJ failed to consider Plaintiff’s

23

1 two children but had to stop.119 She has a driver’s license and drives to
2 medical appointments or the grocery store but prefers for her daughter

3

or husband to drive her.120 She will either have her daughter go with

4

her to shop or will order from Walmart to be picked up but does not do

5

shopping.121 Plaintiff said that she lives with her husband and her four

6

children aged 18, 13, 12, and 11.122 She said that she makes sure the

7

8 three younger children get fed and drives them to school but her older

9 daughter drives them home.123 She will only attend events sometimes

10

due to anxiety in crowds.124

11

12

13

14 subjective complaints regarding limitations in the use of her right arm

15

and upper extremity.

16

119 AR 1158-1159.

17

120 AR 1159.

18

121 AR 1159-1160.

19

20 122 AR 1160.

21 123 Id. 22

124 Id. 23

1 Plaintiff said she is 5’6” and 218 pounds and that she is right-

2 handed.125 She walks with a crutch prescribed by her doctor several

3

weeks prior due to a sprained ankle.126 On April 8, 2025, she had a

4

debridement procedure of her right shoulder and was scheduled for a

5

consultation for rotator cuff surgery.127 Prior to the debridement she

6

was not able to move her shoulder at all.128 Plaintiff said she had issues
7

8 with reaching and that even doing a puzzle was difficult.129 She said

9 that with regard to her hand she could open a car door, use keys, use a

10

knife and fork, and “sometimes could open a jar.130 She said she could

11

shave and comb her hair but that shaving her upper arms was difficult

12

because she could not lift her right arm.131 She said that she wears a

13

14

15

125 AR 1161.

16

126 Id. 17

127 AR 1161-1162.

18

128 AR 1162.

19

20 129 Id. 21 130 Id. 22

131 AR 1162-1163.

23

1 splint or hand brace to help with use of her right hand and takes

2 ibuprofen for pain.132 Plaintiff said she also has knee pain but does not
3

get treatment because she has learned to elevate her leg as needed and

4

would be consulting with her doctor in two weeks about her leg because

5

she injured it when she recently fell.133 She said that before she fell she
6

elevated her leg but not as often.134

7

8 Plaintiff testified that she is seeing a therapist and taking

9 psychiatric medications benzoaxazine, Lamotrigine, buproprion, and

10

buspirone.135 She said that she suffers from depression, anxiety and

11

panic attacks but has not been hospitalized psychiatrically.136 She said

12

that she can groom herself, can feed the children and sometimes clean

13

but at times cannot.137 She can take medication by using a phone

14

15

16

132 AR 1163.

17

133 AR 1163-1164.

18

134 AR 1164.

19

20 135 AR 1165.

21 136 Id. 22

137 AR 1166.

23

1 reminder and has no hobbies, but will walk for a block.138 Plaintiff said
2 she has childhood friends who she talks to and texts via phone and that

3

she will attend the first hour of church on Sunday.139

4

Plaintiff testified that her knee pain has worsened, and she cannot

5

always stand or walk for 20 to 30 minutes as she used to.140 She said

6

that if she stands or walks for more than 20 minutes she will need to

7

8 elevate her leg above waist level for 20 to 30 minutes to stop swelling.141
9 On a bad day she elevates her leg 3 to 5 times.142 She said that her most
10

recent shoulder surgery was the fifth surgery to her right

11

arm/shoulder.143 She said that 2 to 3 days a week she has tension

12

headaches from using her shoulder and will need to lay down for about

13

14

15

16

138 Id. 17

139 AR 1167.

18

140 AR 1168.

19

20 141 AR 1169.

21 142 Id. 22

143 AR 1170.

23

1 40 minutes.144 In January 2025, she started to get double vision when

2 she had her headaches.145 She had a brain MRI that was normal and

3

the double vision resolved.146

4

Plaintiff testified that she could use her hands for about 20

5

minutes before her hand tingles and she will get tension headaches.147

6

She then needs to rest her hand for 30 minutes before she can use it

7

8 again.148 She said that she can reach for between 1 minute and 5

9 minutes before she has to stop and that if she is working at the counter

10

she has the same restriction.149 She can lift a gallon of milk with her

11

right hand and can lift about 10 to 15 pounds with her left hand. And if

12

she lifts more it will affect her neck and shoulders.150 She said that she
13

14

15

144 AR 1170-1171.

16

145 AR 1171.

17

146 Id. 18

147 AR 1173.

19

20 148 Id. 21 149 AR 1173-1174.

22

150 AR 1174.

23

1 mainly cooks crockpot meals because it is easier.151 Her children and

2 husband have to sweep, clean the bathroom, and do laundry because

3

she cannot do those tasks.152

4

Plaintiff testified that she at times misses appointments or is late
5

due to anxiety because she needs to take about 20 minutes to calm

6

herself when she is getting anxious.153 She gets anxiety attacks about 2

7

8 to 3 times week and can stay out of the house for about 45 minutes

9 before going home but it leaves her exhausted.154 She was unable to

10

watch her friend’s children when her friend wanted her to watch them

11

in the friend’s home instead of her own home.155 Plaintiff testified that
12

her medications make her tired and she will at times nap for 2 hours

13

during the day.156

14

15

16

151 AR 1174-1175.

17

152 Id. 18

153 AR 1175-1176.

19

20 154 AR 1176.

21 155 AR 1177.

22

156 AR 1178.

23

1 2. Relevant Medical Records

2 On January 9, 2023, Plaintiff presented to ARNP Gloria Olsson.157

3

Plaintiff reported that she had been experiencing wrist pain in her right
4

wrist since January 4, 2023, when she went bowling and thought she

5

had aggravated a pre-existing carpal tunnel syndrome.158 On

6

examination, there was tenderness along the lateral wrist.159 ARNP

7

8 Ollson ordered an x-ray of the wrist and prescribed a brace.160 On

9 January 12, 2023, Plaintiff returned to discuss the x-ray results and

10

reported that her pain was unchanged.161 ARNP Olsson noted that the

11

x-ray indicated ossification along the area of pain.162

12

13

14

15

16

157 AR 1455.

17

158 Id. 18

159 AR 1455.

19

20 160 Id. 21 161 AR 1456.

22

162 AR 1457.

23

1 On April 14, 2023, Plaintiff presented to ARNP Olsson and Etasha

2 Bhatt, MD, with continued pain.163 On examination, Plaintiff had

3

exquisite tenderness to palpation along the extensor carpi ulnaris

4

(ECU) tendon in the wrist, pain in the fovea, and clicking in the

5

wrist.164 An MRI taken the same day showed tendinosis and edema at

6

the ECU proximal to the ulnar styloid, partial tear of the triangular

7

8 fibrocartilage (TFCC), as well as a small ganglion cyst.165 On May 11,

9 2023, Plaintiff presented for follow-up, with treatment notes indicating

10

that she had undergone a right wrist arthroscopy with debridement of

11

the TFCC, and right ECU debridement and stabilization after an April

12

MRI had indicated ECU inflammation with calcific tendinitis, and a

13

central TFCC tear.166 Dr. Bhatt noted that Plaintiff continued to

14

15 experience diffuse pain and was going to be transitioned from her

16 current splint over the course of six weeks to a less restrictive splint for
17

18

163 AR 1730.

19

20 164 AR 1730.

21 165 AR 1731-1732.

22

166 AR 1729.

23

1 another 8 weeks and was advised not to flex her wrist.167 Range of

2 motion could not be evaluated due to postop state but sensation to light

3

touch was intact.168

4

At a June 9, 2023 follow-up, Dr. Bhatt notes that Plaintiff had

5

been attending physical therapy and working on hand therapy but her

6

progress was slow.169 At her PT appointment on June 28, 2023, Plaintiff

7

8 reported continued hypersensitivity on the dorsal hand.170 At a July 7,

9 2023, follow-up Dr. Bhatt noted that braces were being discontinued

10

and that he advised Plaintiff that her recovery from the procedure was

11

expected to be very slow.171 On August 2, 2023, Plaintiff complained of

12

pain and hypersensitivity through the dorsal hand.172

13

14

15

16

167 AR 1729.

17

168 Id. 18

169 AR 1714.

19

20 170 AR 1707.

21 171 AR 1701.

22

172 AR 1689.

23

1 On October 5, 2023, Plaintiff presented to Joshua Bales, MD, with

2 complaints of continued right wrist pain over the dorsal radial aspect.173
3

On examination, Plaintiff had a positive Finkelstein’s test, and was

4

diagnosed with DeQuervain’s synovitis.174 Plaintiff wished to try

5

conservative treatment.175 On November 13, 2023, Dr. Bales noted that

6

conservative treatment, including injections, had failed and surgical

7

8 release was necessary.176 On November 28, 2023, Plaintiff underwent

9 surgery and presented on December 12, 2023, for her first post-op

10

visit.177

11

In April 2024, Plaintiff presented to the Emergency Department of

12

Kadlec Regional Medical Center, with reports that she had injured her

13

right hand.178 An x-ray of the right hand showed cortical irregularities

14

15

16

173 AR 1668.

17

174 AR 1670-1671.

18

175 Id. 19

20 176 AR 1667.

21 177 AR 1660.

22

178 AR 1638-1639.

23

1 most prominent in the 2nd to 5th digits and appearing progressed from

2 prior examinations.179 At a May 16, 2024 follow-up, Plaintiff reported

3

continued pain of a mild to moderate severity.180

4

On August 6, 2024, Plaintiff presented to ARNP Monica Mendoza

5

with complaints of ongoing tingling and pain in her right shoulder.181

6

Plaintiff reported that the symptoms started 2 months prior and

7

8 worsened over time, and were affecting her ADL’s such as brushing her

9 hair.182 On examination, Plaintiff’s right shoulder was tender and she

10

had a positive Hawkin’s and empty can test on the right shoulder.183

11

ARNP Mendoza suspected a rotator cuff injury and referred Plaintiff to

12

physical therapy with a scheduled follow-up in 4 weeks.184 At a follow-

13

up appointment on September 9, 2024, Plaintiff reported that her right

14

15

16

179 Id. 17

180 AR 1623.

18

181 AR 1488.

19

20 182 AR 1489.

21 183 AR 1489-1490.

22

184 AR 1488.

23

1 shoulder pain persisted despite physical therapy.185 On examination,

2 her shoulder had decreased range of motion behind her back and with

3

overhead motion.186 An MRI taken on September 20, 2024, indicated as

4

follows:

5

1. Moderate supraspinatus and infraspinatus tendinosis

6

without a discrete high-grade tear.

2. Focal intermediate signal intensity in the distal

7

supraspinatus tendon measuring 0.4 cm in AP diameter is

8 favored to represent focal insertional tendinosis. A small

intrasubstance tear cannot be entirely excluded but is felt to

9 be less likely.

3. Focal T1/T2 signal hypointensity in the posterior fibers of

10

the infraspinatus tendon insertion measuring 0.4 cm,

11 suggestive of calcific tendinitis.

4. Small focal articular surface tear in the cranial fibers of the

12 subscapularis tendon insertion, superimposed on mild

tendinosis.

13

5. Mild tendinosis of the intra-articular long head of the biceps

tendon.

14

6. Moderate to severe degenerative changes of the

15 acromioclavicular joint.

7. Trace fluid in the subacromial-subdeltoid bursa, which can

16 be seen in the setting of bursitis.

17

18

19

20

21 185 AR 1492.

22

186 AR 1493.

23

1 On March 3, 2025, Plaintiff presented to orthopedist Jason

2 Dutton, DO, of Kadlec Clinic Northwest.187 Dr. Dutton noted that

3

Plaintiff was complaining of problems with the right shoulder persisting

4

for 6-7 months despite having 2 injections in her shoulder and a round

5

of physical therapy.188 Dr. Dutton noted that Plaintiff’s prior surgeries
6

included a right knee joint replacement in 2008, left carpal tunnel

7

8 release in January 2015, right carpal tunnel release in February 2015,

9 right need radio ablation procedure in May 2019, right knee joint

10

replacement in May 2020, right knee joint manipulation and injection

11

in July 2020, a right wrist arthroscopy with debridement of the extensor

12

carpi ulnar tendon in April 2023, and a right wrist DeQuervain’s

13

release in November 2023.189 On examination, Dr. Dutton noted

14

15 tenderness to palpation on the front part of the shoulder over the Ac

16 joint and along the occipital groove, had abduction to 165 degrees with

17

pain, and had a positive speed test, O’Brien’s test, Hawkins test, and

18

19

20 187 AR 1542.

21 188 Id. 22

189 AR 1542-1543.

23

1 Neer’s test.190 An MRI taken that same day indicated findings similar to

2 those found on September 20, 2024.191

3

Dr. Dutton diagnosed tear of the right rotator cuff, arthralgia of

4

right acromioclavicular joint, and biceps tendinitis of the right upper

5

extremity.192 He recommended a right shoulder diagnostic arthroscopy

6

with rotator cuff repair.193

7

8 3. The ALJ’s Reasoning Regarding Plaintiff’s Subjective

9

Complaints

10

The ALJ articulated the following reasoning regarding his

11

consideration of Plaintiff’s subjective complaints regarding her right

12

upper extremity:

13

14 Next, the undersigned considered the claimant’s right

shoulder and right upper extremity impairments but finds

15 that the medical evidence does not fully support the extent of

the claimant’s subjective allegations.194

16

17

190 AR 1545.

18

191 AR 1546.

19

20 192 AR 1546.

21 193 AR 1547.

22

194 AR 1137.

23

1

The ALJ went on to recite that at her consultative examination in

2

January 2021, Plaintiff did not complain of any issues affecting her

3

4 upper extremities but that in January 2023 she reported right wrist

5 pain and was diagnosed with tendinosis in April 2023 after an MRI was

6

taken; that she underwent an arthroscopy in and reported doing well

7

until she developed numbness over the ulnar nerve in September 2023;

8

that in 2023 Plaintiff was diagnosed with DeQuervain’s tenosynovitis in

9

November 2023 and underwent surgery, but still had tenderness post-

10

11 surgery; that in August 2024, Plaintiff complained of right shoulder

12 pain and was found after examination to be suffering from a rotator cuff

13

tear causing pain and reduced range of motion; that in November 2024,

14

a nerve conduction text indicated incomplete healing of Plaintiff’s

15

carpal tunnel syndrome; and that in March 2025 it was noted that

16

Plaintiff continued to suffer from right shoulder pain and limitation of

17

18 motion following injection and a debridement procedure.195

19 The ALJ went on to state:

20

21

22

195 AR 1137-1138.

23

1 The undersigned has accounted for the full effects of the

claimant’s right shoulder and right upper extremity

2 impairments, in combination, in including the limitations to

frequently handle and reach with the right upper extremity

3

and in the inclusion of having only occasional exposure to

4 hazards, extreme temperatures, and vibration.196

5 He also reasoned:

6

In evaluating the claimant’s symptoms under SSR 16-3p, the

undersigned finds the evidence only partially supports the

7

alleged loss of functioning. As indicated above, the medical

8 evidence showed the claimant to have experienced

improvement after undergoing her knee procedures

9 (Exhibits 8F/20; 11F/8; 13F). The evidence has not shown the

claimant to have sought out or to have received medical

10

treatment for her knee impairments since approximately

11 2020 (Exhibit 11F/6). Additionally, although the claimant

has reported having difficulties with her right upper

12 extremity, she also testified at the May 8, 2025 hearing that

she is able open a car door, use utensils, use keys, drink from

13

a glass, shave, comb her hair, and make grocery lists. As for

her mental impairments, despite the claimant testifying that

14

she wants to stay in bed, she also testified that she takes her

15 children to school daily, prepares meals for them, attends to

her personal hygiene, and that she attends religious services

16 weekly (Hearing Testimony).197

17

18

19

20

21 196 AR 1138.

22

197 AR 1139.

23

1 4. Analysis

2 It is of note that among Plaintiff’s listed severe impairments are

3

four separate impairments affecting the use of Plaintiff’s dominant

4

right upper extremity.198 Yet, there is no medical opinion contained in

5

the record regarding Plaintiff’s limitations in the use of her dominant

6

extremity, despite the fact that in the two year prior to the hearing she
7

8 had undergone 5 separate surgeries to her hand, wrist, and shoulder.

9 “The ALJ always has a special duty to fully and fairly develop the

10

record” to make a fair determination as to disability, even where, as

11

here, “the claimant is represented by counsel.”199 This “affirmative

12

responsibility to develop the record” is necessary to ensure that the

13

ALJ’s decision is based on substantial evidence.200

14

15 On this record, without a treating or examining medical opinion,

16 the Court “cannot conclude that the ALJ’s decision was based on

17

18

19

20 198 AR 1132.

21 199 Celaya v. Halter, 332 F.3d 1177, 1183 (9th Cir. 2003) (cleaned up).

22

200 Id. at 1184.

23

1 substantial evidence . . . [when taking] the totality of [the claimant’s]

2 conditions into account.”201

3

As noted, the ALJ must identify what symptom claims are being

4

discounted and clearly and convincingly explain the rationale for

5

discounting the symptoms with supporting citation to evidence.202 This

6

7

8

201 Id. 9

202 Smartt v. Kijakazi, 53 F.4th 489, 499 (9th Cir. 2022). Factors to be

10

considered by the ALJ when evaluating the intensity, persistence, and

11

limiting effects of a claimant’s symptoms include: 1) daily activities; 2)
12

13 the location, duration, frequency, and intensity of pain or other

14 symptoms; 3) factors that precipitate and aggravate the symptoms; 4)

15

the type, dosage, effectiveness, and side effects of any medication the

16

claimant takes or has taken to alleviate pain or other symptoms; 5)

17

treatment, other than medication, the claimant receives or has received

18

for relief of pain or other symptoms; 6) any non-treatment measures the

19

20 claimant uses or has used to relieve pain or other symptoms; and 7) any

21 other factors concerning the claimant’s functional limitations and

22

restrictions due to pain or other symptoms. 20 C.F.R. §§ 404.1529 (c),

23

1 requires the ALJ to “show his work” and provide a “rationale . . . clear

2 enough that it has the power to convince” the reviewing court.203

3

There is no indication that the ALJ has medical training which

4

would allow him to interpret the raw medical data and make his own

5

medical assessment of the functional limitations following Plaintiff’s

6

surgery.204 Yet, the ALJ has articulated that a limitation to frequent

7

8 handling and reaching is sufficient to account for Plaintiff’s severe

9 impairments without explanation as to how, for instance, such a

10

limitation is consistent with the expected symptoms of a rotator cuff

11

tear. The ALJ has not explained how he arrived at his conclusions when

12

13

14

15

416.929(c); Ghanim v. Colvin, 763 F.3d 1154, 1163 (9th Cir. 2014); Soc.

16

Sec. Rlg. 16-3p, 2016 WL 1119029, at *7.

17

203 Smartt v. Kijakazi, 53 F.4th 489, 499 (9th Cir. 2022) (alteration

18

added).

19

20 204 ALJs cannot usurp the role of doctors when interpreting medical

21 evidence, particularly highly technical medical evidence. Trevizo v.

22

Berryhill, 871 F.3d 664, 683 (9th Cir. 2017).

23

1 formulating the RFC. Instead, he offered a conclusory opinion of the

2 expected limitations.205

3

5. Summary

4

Again, the Court concludes that remand is warranted to develop

5

the medical record and orders that the ALJ be directed to schedule a

6

7 consultative examination to obtain a medical opinion as to the

8 limitations in Plaintiff’s use of her right upper extremity, and to call a
9

medical expert to testify as to the expected physical limitations from

10

Plaintiff’s arm and shoulder in addition to those of her knee.

11

Specifically, the Court directs that the medical expert opine as to

12

whether there was any period of twelve months or more during which

13

14 Plaintiff’s limitations would have precluded light and/or sedentary

15 work.

16

As discussed above, the ALJ failed to consider the medical record

17

as a whole when considering the medical opinions. Because the Court

18

has remanded the case for consideration of the record as a whole, the

19

20

21

22

205 See Garrison v. Colvin, 759 F.3d 995, 1013-14 (9th Cir. 2014).

23

1 ALJ will be required to consider the credibility of Plaintiff’s subjective
2 complaints.

3

C. Step Two: This issue is moot.

4

Because the Court has remanded the case for further development

5

of the record, all of Plaintiff’s physical impairments, including

6

headaches, will be reconsidered. Accordingly, this issue is moot.

7

8 D. Remand for Further Proceedings

9 Plaintiff submits a remand for payment of benefits is warranted.

10

The decision whether to remand a case for additional evidence, or

11

simply to award benefits, is within the discretion of the court.”206 When
12

the court reverses an ALJ’s decision for error, the court “ordinarily must
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remand to the agency for further proceedings.”207

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206 Sprague v. Bowen, 812 F.2d 1226, 1232 (9th Cir. 1987) (citing Stone

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v. Heckler, 761 F.2d 530 (9th Cir. 1985)).

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20 207 Leon v. Berryhill, 880 F.3d 1041, 1045 (9th Cir. 2017); Benecke 379

21 F.3d at 595 (“[T]he proper course, except in rare circumstances, is to

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remand to the agency for additional investigation or explanation”);

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1 The Court finds that further development is necessary for a proper

2 disability determination. Here, while it appears clear that Plaintiff

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suffered disabling limitations, it is not clear when those limitations

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became disabling or were expected to improve to a point they were no

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longer disabling. Therefore, the ALJ should schedule a consultative

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examination and call a medical expert to testify as to Plaintiff’s physical
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8 limitations, properly consider the opinion evidence, and make findings

9 at each of the five steps of the sequential evaluation process.

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IV. Conclusion

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Accordingly, IT IS HEREBY ORDERED:

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1. The ALJ’s nondisability decision is REVERSED, and this

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matter is REMANDED to the Commissioner of Social

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15 Security for further proceedings pursuant to sentence four of

16 42 U.S.C. § 405 (g).

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21 Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1099 (9th Cir.

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2014).

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1 2. The Clerk’s Office shall TERM the parties’ briefs, ECF Nos.
2 11 and 13, enter JUDGMENT in favor of Plaintiff, and
° CLOSE the case.
IT IS SO ORDERED. The Clerk’s Office is directed to file this

6 order and provide copies to all counsel.

7 DATED this 2"¢ day of March 2026.

                            awd |   ew. 
                       —aDWARD F. SHEA 

10 Senior United States District Judge

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                                                    DISPOSITIVE ORDER - 5